Hepatitis Flashcards
hepatitis is simply
Inflammation of the liver
Hepatitis viruses
replicate specifically in hepatocytes (hepatotropic) causing destruction
HepA transmission
faeco-oral
HepB transmission
Blood/sex/vertical
HepC transmission
Blood/sex
when does jaundice occur
- Occurs when there is a high level of bilirubin the blood
bilirubin is
the normal breakdown product from catabolism of haem formed from destruction of RBC
under normal circumstances bilirubin undergoes
1) conjugation in the in the liver (UDP glucoronyl transferase) making it water soluble
2) Excreted via the bile into the GI tract – majority egested in the faeces as urobilinogen and stercobilin
3) 10% of urobilinogen is reabsorbed into the bloodstream and excreted through the kidney
types of jaundice
pre-hepatic
hepatocellular
post-hepatic
pre-hepatic
- Excessive red cell breakdown which overwhelms the liver ability to conjugate bilirubin
- Overwhelms the livers ability to conjugate bilirubin unconjugated bilirubin remains in the blood stream to cause jaundice
- Examples:
• Haemolytic anaemia
• Sickle cell
Hepatocellular
- Dysfunction of the hepatic cells
- Liver loses the ability to conjugate bilirubin
- Liver cirrhosis may compress intra-hepatic portions of the biliary tree to cause obstruction
- Leads to both unconjugated and conjugated bilirubin in the blood- mixed picture
- Examples:
• Alcohol liver disease
• Viral hepatitis
• Cirrhosis
• Pregnancy
Post-hepatic
- Obstruction of biliary drainage
- Bilirubin that is not excreted will have been conjugated by the liver –> conjugated hyperbilirubinaemia
- Examples
• Intra-luminal causes such as gall stone
jaundice biomarkers
- bilirubin
- albumin
- AST
- ALT
- Alkaline phosphatase
bilirubin as a marker
quantify degree of any suspected jaundice
Albumin as a marker
marker of the liver’s synthesising function
